Breast cancer: how hippotherapy bridges the gap between healing and recovery. A randomized controlled clinical trial.

Abstract

Abstract Background: Breast cancer is the most diagnosed women’s cancer with a high survival rate nowadays. Because cancer is a systemic disease characterized by variable course, heterogeneity and unequal environmental inputs, disparities in the persons’ future are the norm. Despite enormous progress in early accurate detection and treatment’s effectiveness/precision, life reconstruction is well beyond the current care path. It requires comprehensive cross-sectoral approaches between different knowledge areas and deeper consideration of the challenges the patients have to deal with. The psychological and social sciences must be integrated to the physiological sciences to build a robust patient-centered healthcare practice. Methods: We conducted a randomized open, prospective, two-arms controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy), according to strict inclusion and exclusion criteria. The 6-months program included, in the treated group, an initial 1-week daily hippotherapy session followed by three short 2-days sessions with an interval of 2 months between each where the patients received conventional supportive care. On the other hand, the control group received a 6-month conventional supportive care. The primary end point was quality of life, whereas cognitive performances, fatigue, anxiety and depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. Results: We observed statistical differences for each measurement test and items between the treated and control group. Indeed, the treated group showed a significant and continuous improvement of quality of life, cognitive performance, fatigue, anxiety and depression, and body image as early as the first week after hippotherapy treatment compared to the conventional supportive care group. Conclusions: We demonstrate through this clinical trial, the therapeutic relevance of hippotherapy, an one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on treatments’ efficiency and reconstruction of the individuals’ shattered life and their ecosystem. This work reveals a layer of complexity that needs to be broadly considered. Trial registration: ClincalTrials.gov NCT04350398. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.